{"data":{"id":"us-ky/krs-304.11-045","jurisdiction":"us-ky","citation":"KRS 304.11-045","heading":"Jurisdiction over providers of health care benefits.","body":"(1) The purpose of this section is to give Kentucky jurisdiction over providers of health\ncare benefits; to indicate how each provider of health care benefits may show under\nwhat jurisdiction it falls; to allow for examination by Kentucky if the provider of\nhealth care benefits is unable to show it is subject to another jurisdiction; to make\nsuch a provider of health care benefits subject to the laws of Kentucky if it cannot\nshow that it is subject to another jurisdiction; and to disclose to purchasers of such\nhealth care benefits whether or not the plans are fully insured.\n(2) Notwithstanding any other provision of law, and except as provided herein, any\nperson or other entity which provides coverage in this state for medical, surgical,\nchiropractic, physical t herapy, speech pathology, audiology, professional mental\nhealth, dental, hospital, or optometric expenses, whether such coverage is by direct\npayment, reimbursement, or otherwise, shall be presumed to be subject to the\njurisdiction of the department, unles s the person or other entity shows that while\nproviding such services it is subject to the jurisdiction of another agency of this\nstate, any subdivision thereof, or the federal government.\n(3) If a person or entity wishes to show that it is subject to the jurisdiction of another\nagency of this state, any subdivision thereof, or the federal government, such\nshowing shall be made by providing to the commissioner the appropriate certificate,\nlicense, or other document issued by other governmental agency which permits or\nqualifies it to provide those services.\n(4) Any person or entity which is unable to show under subsection (3) that it is subject\nto the jurisdiction of another agency of this state, any subdivision thereof, or the\nfederal government, shall submi t to an examination by the commissioner to\ndetermine the organization and solvency of the person or the entity, and to\ndetermine whether or not such person or entity complies with the applicable\nprovisions of this chapter.\n(5) Any person or entity unable t o show that it is subject to the jurisdiction of another\nagency of this state, any subdivision thereof, or the federal government, shall be\nsubject to all appropriate provisions of this code regarding the conduct of its\nbusiness.\n(6) Any production agency or administrator which advertises, sells, transacts, or\nadministers the coverage in this state described in subsection (2) of this section and\nwhich is required to submit to an examination by the commissioner under\nsubsection (4) of this section shall, if said coverage is not fully insured or otherwise\nfully covered by an authorized life or health insurer, nonprofit hospital, medical -\nsurgical, dental, and health service corporation, health maintenance organization, or\nprepaid dental plan organization, advise every purchaser, prospective purchaser, and\ncovered person of such lack of insurance or other coverage. Any administrator\nwhich advertises or administers the coverage in this state described in subsection (2)\nof this section which is required to submit t o an examination by the commissioner\nunder subsection (4) of this section shall advise any production agency of the\nelements of the coverage, including the amount of \"stop loss\" insurance in effect.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=17007","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:41Z","sha256":"9e990af8c00246a4c139ea4f6cd0ef4416f6266aef95fb5108a2b1eb4b703546","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.11-042","next":"us-ky/krs-304.11-050"},"notice":"GroundRules: Original legal text. Not legal advice."}